Epileptic burn injuries in Kashmir valley: Is “Kangri” a boon or bane?

Abstract

Background: During seizure attacks, patients may suffer severe trauma such as deep burns, limb fractures, and head-and-neck injuries. Most burns in epileptic patients occur during major seizures. Such burns are always full-thickness. Because of extreme cold conditions people in Kashmir valley, especially in rural areas use Kangri to keep themselves warm. This Kangri which is already notorious for causing Kangri cancer has an additional disadvantage in causing deep burns mainly to the hands in epileptic patients. Objective: (1) To analyze the epidemiological data of burnt hospitalized epileptic patients. (2) To determine the frequency, causes, and consequences of burns in patients with epilepsy stressing on Kangri burns in epileptics. (3) To determine the various preventive measures to reduce the incidence of such injuries. Materials and Methods: This was a retrospective study conducted in the Department of Burns, Plastic, and Reconstructive Surgery at Sher-e-Kashmir Institute of Medical Sciences, Srinagar, India, from January 2005 to December 2018. All epileptic patients with burns admitted in the hospital were included in the study. Results: Of 157 patients, 67 (43%) were in the age group of 16–30 years. The mean age was 32.7 years. Majority of the patients 99 (63%) were female. One hundred and two (84%) patients belonged to rural areas. Kangri was the most common etiological agent of epileptic burns in 99 (63%) patients. Eighty-four (53%) had sustained full-thickness burns and total body surface area involved was up to 5% only. The most common site of burns was hands 88 (56%). Amputation of the gangrenous digits/hands was the most common surgery performed in 39 (25%) patients. Complication in burnt epileptic patients was loss of a body part 47 (44%) followed by contracture (32.4%), wound infection (22%), and loss of vision in 1 (0.6%) patients. There was no mortality in our series. Conclusion: Epileptic patients should avoid high-risk situations like working alone in kitchen. Kangri should be replaced by alternative simple and safe warming devices.